Campus Cost Hike for Birth Control Sets Off Concerns

By David Abel and Sarah Schweitzer
The Boston Globe

Monday 10 September 2007

An increase in the price for prescription birth control obtained at campus health centers has some college officials worried that students will be at greater risk for unwanted pregnancies.

The price of prescription contraception, including pills, patches, and other devices, sold by schools has jumped, with a package of birth control pills going from about $7 to between $30 and $50, according to local college health officials. The increase was the result of a change in the 2005 Medicaid rebate law that eliminated the large discounts drug companies had offered to college health clinics.

Although the law has been in place since January, students are feeling the effects now because schools' stockpiles of the discounted prescriptions are running out.

The price increase has left Massachusetts college campuses scrambling to accommodate students' needs.

Some campus health services, including those at Mount Holyoke College, University of Massachusetts at Boston, and Fitchburg State College, this year will forgo offering birth control pills and will instead write prescriptions for students to be filled at local pharmacies.

Since 1989, full-time college students in Massachusetts have been required to have health insurance, either through their school or independently, so most students will be able to get prescription oral contraception for about $10 for generics and $20 for brand names, health officials said.

But health advocates say that some students will not want to switch to generic birth control because of the potential for side effects.

Another concern is that students may be allowed to buy only one month's supply of birth control pills at a time, rather than stocking up with several months' worth as they formerly could.

"The likelihood of there being some gaps in usage will increase," said Karen Engall, director of Mount Holyoke's health services.

Health officials also worry that some students will not use insurance to buy contraception because their parents see the pharmacy bills. Until January, colleges bought contraceptives and other drugs at reduced prices from pharmaceutical companies, sometimes charging students a bit extra to finance other health programs on campus. The Deficit Reduction Act of 2005, which took effect at the start of this year, ended the incentive for companies to sell discounted drugs.

Health advocates said the effect on colleges was inadvertent, and lobbyists have been pressuring Congress to reinstate the discounts.

"All signs point to this being an oversight, and there's only one way to fix it - and it will cost no [taxpayer] money," said Mary Hoban, director of the health assessment program of the American College Health Association. "We just ask the nominal price exemption be reinstated. Our bottom line is keeping young people well."

Hoban said that about 38 percent of female university students use oral contraceptives.

Melissa Wagoner, a spokeswoman for Senator Edward M. Kennedy, said senators are looking into changing the law. "It's been under discussion for some time and could be considered on any number of bills," she said.

The change in prices has some students concerned.

"Most people in college are not working and they don't have extra money to spend on birth control," said Alexandra Hatzopoulos, 18, a freshman at UMass-Boston.

Imani Williams, a sophomore at UMass-Boston, said, "If the problem is children having children, then contraception shouldn't cost so much."

UMass-Boston officials said they still have stockpiles of low-priced birth control, but expect to run out soon and will begin writing prescriptions for students to fill at pharmacies.

Angus G. McQuilken, a spokesman for the Planned Parenthood League of Massachusetts, said his organization has been lobbying Congress to change the law.

"Birth control is basic healthcare. Making birth control less affordable for college students and low-income women is bad public policy, and counter to the goal of reducing unintended pregnancies," he said.

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